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CLEAR FORM

ACCOUNT APPLICATION
WWW.WEDBUSH.COM MEMBER NYSE FINRA SIPC IE For Office Use Only: * Please indicate information being updated: Account Number: New Account Update to Existing Account*

1. ACCOUNT TYPE: Please check one box only.


Individual Joint (rights of survivorship) Custodian for Minor C-Corporation Sole Proprietorship Estate/Conservatorship Personal Trust Retirement Trust ** For AZ, CA, ID, LA, NV, NM, TX, WA and WI only. Joint (tenancy in common) S-Corporation LLC/LLP Other Joint (community property**) Partnership Voluntary Association IRA (Must accompany form I) KEOGH (Contact Retirement Services)

2. ACCOUNT INFORMATION
FULL TITLE OF ACCOUNT TAXPAYER ID NUMBER:

OPTIONAL ACCOUNT FEATURES


CREDITPLUS ACCOUNT Checkwriting and Wedbush Gold Card (If yes, please complete form CP) OPTION ACCOUNT If you wish to trade Options, please complete form OA Yes No Yes No

3. APPLICANT INFORMATION: This section must be completed for all account types
Primary Applicant and/or Beneficial Owner Information Full Legal Name
First Middle Last Suffix

Co-Applicant Information Full Legal Name


First Middle Last Suffix

Home Street Address (Cannot be a P.O. Box) City State Zip

Home Street Address (Cannot be a P.O. Box) City State Zip

Mailing Address (If different from above. P.O. Box may be used) City Home Phone E-mail Address Date of Birth (mm/dd/yyyy) Marital Status Single Social Security Number Number of Dependents: Not Employed Alternate Phone State Fax Zip

Mailing Address (If different from above. P.O. Box may be used) City Home Phone E-mail Address Date of Birth (mm/dd/yyyy) Marital Status Single Social Security Number Number of Dependents: Not Employed Alternate Phone State Fax Zip

Married

Married

Employment Information Employed Self-Employed Retired Student Occupation (if retired, former Occupation) Type of Business Employer Business Address City State Business Phone

Employment Information Employed Self-Employed Retired Student Occupation (if retired, former Occupation) Type of Business Employer Business Address Business Phone

Zip

City

State

Zip

Identification Information (Please attach copy) Type of ID: Drivers License Passport Other (describe) _______________ Identification # Issue Date State/Country of Issuance Country of Citizenship Country of Legal Residence Country of Tax Residence US US US Expiration Date Other Other Other

Identification Information (Please attach copy) Type of ID: Drivers License Passport Other (describe) ______________ Identification # Issue Date State/Country of Issuance Country of Citizenship Country of Legal Residence Country of Tax Residence US US US Expiration Date Other Other Other

4. INDUSTRY AND OTHER AFFILIATIONS


Are you, your spouse, or any other immediate family members, including parents, in-laws, siblings and dependents: Primary Applicant Co-Applicant Yes No Yes No Employed by or associated with Wedbush Securities? If yes, what is the relation? Yes No Yes No Employed by or associated with a registered broker/dealer (other than Wedbush) or a financial regulatory agency ? If yes, please specify entity below. If employed by the entity and, if required, please provide a letter from your employer (with this Application) approving establishment of this account. Name of Entity: Yes No Yes No An officer, director or 10% (or more) shareholder in a publicly owned company? Name of Compan(ies) and Symbol(s):

Applicant Initials Co-Applicant Initials

For Office Use Only: Annual Income $ 50,000 or less $500,000 or less $100,000 or less $1 million or less $200,000 or less Over $1 million

IE

Account Number: Total Net Worth (excluding home) $ 50,000 or less $500,000 or less $100,000 or less $1 million or less $200,000 or less Over $1 million Risk Tolerance I want to preserve my initial principal in this account, with minimal risk, even if it means this account does not generate significant income or returns and may not keep pace with inflation. I am willing to accept some risk to my initial principal and tolerate some volatility to seek higher returns, and understand I could lose a portion of the money invested. I am willing to accept maximum risk to my initial principal to aggressively seek maximum returns, and understand I could lose all, or most all, of the money invested. Tax Bracket

5. INVESTMENT PROFILE: This section must be completed for all account types
Liquid Net Worth (cash, securities, etc.) $ 50,000 or less $500,000 or less $100,000 or less $1 million or less $200,000 or less Over $1 million

%
Decline to state

Investment Objective(s) If choosing more than one objective, please rank in order of priority. Income Growth
(also called Capital Gains)

Emphasis on investments that generate income. Emphasis on investments more likely to appreciate in principal rather than generate income. Emphasis on potential for significant appreciation; willing to accept a high risk for loss of principal. Seeks to take advantage of short tern trading opportunities. High turnover, high risk. Aggressive Emphasis on investments that are most likely to preserve principal. Low risk. 5 + years Conservative

Speculation

Moderate

Trading

Conservation of Capital

Investment Experience None < 5 years Stocks Bonds Options Mutual Funds Annuities Partnerships Other ____________

Yes No I wish to allow illiquid investments in this account. Source of Funds Investment Allocation Wages/Income The investments in this account will be (check one): Pension or Retirement Less than 1/3 of my financial portfolio Funds from another account Roughly 1/3 to 2/3 of my financial portfolio More than 2/3 of my financial portfolio Savings Sale of business or property Investment Knowledge Insurance payout Limited Moderate Extensive Gift/Inheritance Investment Time Horizon Other _____________________ 0 to 5 years 5 to 10 years over 10 years Yes No Liquidity Needs (percent of portfolio you anticipate withdrawing) Under 1 year 1 to 5 years 5 to 10 years Over 10 years

You may disclose my name, address and security positions to requesting companies in which I hold securities under Rule 14b-1(c) of the Securities and Exchange Commission. All information Essential information only I wish to receive Please indicate dividend handling instructions: Hold Send Reinvest

6. MUST BE SIGNED BY ALL APPLICANTS I affirm I wish to open (please check only one) CASH ACCOUNT MARGIN ACCOUNT AND CASH ACCOUNT MONTHLY ACCOUNT STATEMENTS I affirm I have supplied a valid e-mail address and wish to receive the following electronically:
TRADE CONFIRMATIONS

I wish to have this account added to the household under primary account number _______________________ By signing below, I agree to advise you promptly in writing of any material changes to the information provided. By signing below, I affirm I have received the Client Account Agreement booklet. I also acknowledge that I have read, understand and agree to all terms and conditions in the Client Account Agreement (Form CAA) and the Disclosure Statement (Form DS). If I have selected Margin Account, I acknowledge I have read, understand and agree to all terms and conditions in the margin agreements (Form M and Form M-1). If this is a Joint Account, I affirm I have read, understand and agree to all the terms in the Joint Account Agreement (Form J).

I ACKNOWLEDGE THAT THIS AGREEMENT ALSO CONTAINS A PREDISPUTE ARBITRATION PROVISION UNDER PARAGRAPH X OF THE CLIENT ACCOUNT AGREEMENT (FORM CAA).
IRS Substitute Form W-9 (Request for Taxpayer Number and Certification) Under penalties of perjury, I certify 1) that the number supplied hereon is my correct taxpayer identification number, 2) that I am not subject to backup withholding as a result of failure to report all interest and dividends, or the Internal Revenue Service has notified me that I am no longer subject to backup withholding (if you have been notified by the IRS that you are subject to backup withholding, you must cross out certification 2, above), and 3) I am a U.S. citizen or other U.S. person (as defined in the instructions available at www.irs.gov). The IRS does not require your consent to any provisions of this document other than the certification to avoid backup withholding. Applicant Signature: Co-Applicant Signature: Print Name: Print Name: Approvals FOR OFFICE USE ONLY Date: Date:

IE Signature SOM Signature Div. Mgr. Signature Date Client Account Agreements Furnished:
(Form NA rev 08/2011)

Printed Name Printed Name Printed Name

Date Date Date BRR Date:

*ef0001*